Individual
SOWMYA RAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(469) 450-0079
Mailing address
230 EATON RIDGE DR APT 104, SAGAMORE HILLS, OH 44067-4511
(469) 450-0079
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06752
TX
363AM0700X
Medical Physician Assistant
5047
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305727501
—
TX
Enumeration date
05/13/2010
Last updated
09/23/2021
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